本文選題：嗜酸性粒細胞增多癥　切入點：潑尼松　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析25例門診嗜酸性粒細胞增多癥患兒的臨床特點及治療療效,旨在給臨床醫(yī)生在制定治療策略上提供有益幫助及依據(jù)。方法:回顧性分析2013年1月至2017年1月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院兒科門診就診的25例嗜酸性粒細胞增多癥患兒臨床資料,應(yīng)用SPSS20.軟件進行統(tǒng)計學(xué)分析。結(jié)果:1.在25例嗜酸性粒細胞增多癥患兒中,男孩18例,女孩7例,男女比例約為2.57:1。25例患兒診斷時的年齡為2~13歲,平均年齡5.8歲。2.外周血嗜酸性粒細胞數(shù)輕度增多3例(12%),中度增多12例(48%),重度增多10例(40%)。外周血AEC增高程度與性別、年齡無關(guān)(P0.05)。3.病因包括感染6例(24%),其中EB病毒感染1例(4%),寄生蟲感染5例(20%),包括鉤蟲感染2例,人芽囊原蟲1例,2例臨床診斷寄生蟲感染;過敏性蕁麻疹2例(8%);病因不明確17例(68%)。4.25例患兒中以皮膚受累表現(xiàn)多見,為17例(68%),全身表現(xiàn)為9例(36%),呼吸系統(tǒng)及消化系統(tǒng)表現(xiàn)各為8例(32%)、5例(20%)。5.25例患兒外周血AEC范圍為1.1~25.84×109/L,平均值為8.30×109/L,其中17例(68%)患兒白細胞計數(shù)明顯升高。6.5例寄生蟲感染患兒,予驅(qū)蟲藥治療1個月后,4例獲得滿意療效,1例患兒治療過程中復(fù)查AEC再次升高。2例過敏性疾病患兒予地氯雷他定治療后癥狀和外周血均獲得緩解。7例患兒采用潑尼松單藥治療,總治療25有效者6例(85.7%)。9例患兒予地氯雷他定治療,總治療有效者有2例(22.2%)。有2例患兒分別予潑尼松聯(lián)合環(huán)孢素、潑尼松聯(lián)合復(fù)方甘草酸苷治療,均獲得PR。25例患兒中有6例因療效欠佳而更改治療方案,4例患兒更換潑尼松治療后療效得到提升;2例患兒改用伊馬替尼治療,其中1例在用伊馬替尼6個月后獲得CR,另1例在予伊馬替尼聯(lián)合潑尼松治療后2個月獲得PR。結(jié)論:1.在嗜酸性粒細胞增多癥兒童中男孩發(fā)病率高于女孩,以學(xué)齡前期多見,幼兒期次之。2.嗜酸性粒細胞增多癥癥狀以皮膚受累多見,消化系統(tǒng)及呼吸系統(tǒng)次之,但臨床表現(xiàn)缺乏特異性。3.多數(shù)嗜酸性粒細胞增多癥患兒潑尼松治療有效。4.嗜酸性粒細胞增多癥患兒在予糖皮質(zhì)激素治療無效時,可考慮使用伊馬替尼治療。
[Abstract]:Objective: to analyze the clinical characteristics and therapeutic effect of 25 outpatients with eosinophilia. The purpose of this study was to provide a useful basis for clinicians in formulating treatment strategies. Methods: a retrospective analysis of 25 cases of eosinophils in pediatric outpatient clinic of the first affiliated Hospital of Guangxi Medical University from January 2013 to January 2017 was conducted. Clinical data of children with polyplasia, Results of 25 cases of eosinophilia, 18 were boys and 7 were girls. The ratio of male to female was about 2.57: 1.25. The age at the time of diagnosis was 21 to 13 years. The mean age was 5.8 years old. The number of eosinophils in peripheral blood increased slightly in 3 cases, in 12 cases, in 12 cases, in 12 cases, in 10 cases, in 10 cases, in 40 cases. The etiology included 6 cases of infection, including 1 case of Epstein-Barr virus infection, 5 cases of parasitic infection, including 2 cases of hookworm infection, 1 case of human bud cyst protozoa and 2 cases of clinical diagnosis of parasitic infection. There were 2 cases with allergic urticaria and 8 cases with irritable urticaria, 17 cases with unclear etiology and 4.25 cases with allergic urticaria showed skin involvement. In 17 cases, there were 9 cases with total body manifestations and 3 with 36%, 8 cases with respiratory system and 5 cases with digestive system, respectively. The range of AEC in peripheral blood of 5 cases was 1.1 ~ 25.84 脳 10 ~ 9 / L, with an average of 8.30 脳 10 ~ (9 / L), of which 17 cases had a significant increase in the white blood cell count of 6.5 cases of parasitic infection, and the mean value was 8.30 脳 10 ~ (9) / L, and the leukocyte count was significantly increased in 6.5 cases of parasitic infection. One month after the treatment, 4 patients received satisfactory curative effect. During the course of treatment, 2 patients with allergic diseases were treated with desloratadine. 7 patients were treated with prednisone alone after the treatment of desloratadine, and the symptoms were alleviated by desloratadine. The total treatment was effective in 6 cases (85.7%) with desloratadine, 2 cases (22.2%) with total treatment and 2 cases with prednisone combined with cyclosporine and prednisone combined with compound glycyrrhizin. Among all the patients with PR.25, 6 patients were treated with imatinib because of poor therapeutic effect. 4 patients were treated with prednisone and 2 patients were treated with imatinib after replacement of prednisone. One case got CRR after 6 months of treatment with imatinib, the other one got PR2 months after treatment with imatinib combined with prednisone. Conclusion: 1.The incidence of Eosinophilia in boys is higher than that in girls, especially in pre-school children. The symptoms of eosinophilia were mainly caused by skin involvement, followed by digestive and respiratory systems. But the clinical manifestation is lack of specificity .3.Most children with eosinophilia can be treated effectively by prednisone .4. the children with eosinophil may consider using imatinib when the glucocorticoid therapy is ineffective.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.5

【參考文獻】

相關(guān)期刊論文 前10條

1 曲士強;秦鐵軍;徐澤鋒;張悅;艾小菲;李冰;張宏麗;方力維;潘麗娟;胡耐博;肖志堅;;單中心60例高嗜酸粒細胞綜合征的臨床特征及長期療效[J];中華血液學(xué)雜志;2016年10期

2 龔若蘭;陳同辛;;淋巴細胞變異型嗜酸性粒細胞增多癥基礎(chǔ)與臨床[J];臨床兒科雜志;2016年09期

3 陳小紅;徐益萍;盧美萍;;88例嗜酸性粒細胞增多癥住院患兒臨床表現(xiàn)及病因分析[J];浙江大學(xué)學(xué)報(醫(yī)學(xué)版);2016年03期

4 郭婕;陳梅;董麗;花少棟;;兒童嗜酸性粒細胞增多綜合征兩例并文獻復(fù)習(xí)[J];中國小兒急救醫(yī)學(xué);2015年03期

5 孫瑞鳳;朱威;;嗜酸性粒細胞增多綜合征的治療進展[J];醫(yī)學(xué)研究雜志;2015年03期

6 陳嘉林;;對嗜酸細胞增多癥的認識[J];中華全科醫(yī)師雜志;2014年11期

7 曲士強;艾小菲;李承文;李慶華;徐澤鋒;秦鐵軍;張悅;肖志堅;;嗜酸性粒細胞增多患者的細胞遺傳學(xué)和分子生物學(xué)特征的研究[J];中國實驗血液學(xué)雜志;2012年05期

8 李學(xué)剛;李碧香;侯麗君;;異常淋巴細胞克隆型高嗜酸細胞綜合征的研究進展[J];白血病.淋巴瘤;2012年05期

9 曲士強;肖志堅;;嗜酸性粒細胞增多癥的診斷分型及治療研究進展[J];國際輸血及血液學(xué)雜志;2011年03期

10 李峰;晉紅中;王寶璽;;嗜酸粒細胞增多綜合征的治療進展[J];國際皮膚性病學(xué)雜志;2009年06期

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